Plot: framing contingency and choice in bioethics

How to "Do Ethics" in Pediatrics Practice: A Framework for Addressing Everyday Ethics Issues

Pediatricians have a fiduciary responsibility to advocate for the best interests of their patients. They accomplish this through the therapeutic alliance with the patient and their parent. In everyday clinical medicine, the pediatrician may be faced with challenging situations. When a case raises concerns, the pediatrician needs to determine if the issues relate to ethical obligations and whether they are in conflict. To resolve the concerns, a systematic process for gathering, organizing, and analyzing the facts of a case is needed to discern morally permissible options. This article presents a framework for performing an ethics case analysis.

Evidence-based medicine and the anecdote: Uneasy bedfellows or ideal couple?

Over the past 30 years, there has been a resurgence in the use of storytelling and narrative in medicine. At first glance, the trend to incorporate art forms into medicine appears to run counter to the rise of the more objective and positivist evidence-based medicine movement. In the present article, the authors provide examples of the use of storytelling and narrative in medicine, describe their origins, and contrast this approach with evidence-based medicine. The authors suggest that storytelling and narrative offer a complement to the science of evidence-based medicine. Finally, the authors describe a program of research to develop and evaluate the use of storytelling as a communication tool between physicians and parents/caregivers of children presenting to the emergency department.